Organization Active NPI

Cheshire Dermatology PLLC

  • Dermatology Physician
  • Cheshire, CT
National Provider Identifier
1134319205
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
029901 Issued in CT
Legal business name
CHESHIRE DERMATOLOGY PLLC
Practice address
677 S Main St
Cheshire, CT 06410-3158
Phone
(203) 250-7577
Fax
(203) 250-0739
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dana Marie Correale, M.D.NPI 1598805277
Title
Owner
Phone
(203) 250-7577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 029901 CT Primary

Addresses

Primary practice location

677 S Main St
Cheshire, CT 06410-3158

Mailing address

677 S Main St
Cheshire, CT 06410-3158
Phone (203) 250-7577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110120000334 CT Part B Supplier - Clinic/Group Practice 2567641780 Receives reassigned benefits from 2 practitioners
Practice locations: Cheshire, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0678677Cheshire Dermatology PLLC677 South Main Street, Cheshire, CT 06410Provider-performed microscopyApr 10, 2028

National Provider Directory

National Provider Directory

Locations

677 S Main St
Ste 3
Cheshire, CT 06410
Phone (203) 250-7577

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1134319205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103158",
            "telephone_number": "203-250-7577",
            "fax_number": "203-250-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103158",
            "telephone_number": "203-250-7577",
            "fax_number": "203-250-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESHIRE DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "CORREALE",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-250-7577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CT",
            "license": "029901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.